HSA-6197 Health Information System and Electronic Health Records

Florida National University

HSA-6197 Health Information System and Electronic Health Records Week 1 Critical Reflection Paper: Chapters 1 & 2 Objective: To critically reflect your understanding of the readings and your ability to apply them to your Health care Setting. ASSIGNMENT GUIDELINES (10%): Students will critically analyze the readings from Chapter 1and 2 in your textbook. This assignment is designed to help you review, critique, and apply the readings to your Health Care setting as well as become the foundation for all of your remaining assignments. You need to read the chapters assigned for week 1 and develop a 2-3-page paper reflecting your understanding and ability to apply the readings to your Health Care Setting. Each paper must be typewritten with 12-point font and double-spaced with standard margins. Follow APA style 7th edition format when referring to the selected articles and include a reference page. EACH PAPER SHOULD INCLUDE THE FOLLOWING: 1. Introduction (25%) Provide a brief synopsis of the meaning (not a description) of each Chapter and articles you read, in your own words. 2. Your Critique (50%) What is your reaction to the content of the articles? What did you learn about the importance of fundamentals in Health Information System? What did you learn HIS Model and its uses? Did these Chapter change your thoughts about HIS? If so, how? If not, what remained the same? 3. Conclusion (15%) Briefly summarize your thoughts & conclusion to your critique of the articles and Chapter you read. How did these Chapters impact your thoughts on Health Information System? Evaluation will be based on how clearly you respond to the above, in particular: a) The clarity with which you critique the chapters; b) The depth, scope, and organization of your paper; and, c) Your conclusions, including a description of the impact of these Chapters on any Health Care Setting. ASSIGNMENT RUBRICS Assignments Guidelines Introduction Your Critique Conclusion Total 10 Points 25 Points 50 Points 15 Points 100 points ASSIGNMENT GRADING SYSTEM A B+ B C+ C D F Dr. Gisela LLamas 90% – 100% 85% – 89% 80% – 84% 75% – 79% 70% – 74% 60% – 69% 50% – 59% Or less. 10% 25% 50% 15% 100% Chapter 2: The Scope, Definition, and Conceptual Model of HIS Introduction • Scope of HIS: all computer systems, networks, and data created and captured by software – The conceptual model: systems and management; health informatics; data and analytics; research, policy and public health • Progression and maturation of HIS – Foundation, use, learning/knowledge, and change • HIS uses in organization and community settings Systems and Their Management Scope of HIS Model for the Health Professions Systems and Their Management • Meaningful health information and data are only as good as the HIS platform and technical foundation that serves as the data source • Data are created and captured in HIS that provide features and functions to support • Workflows (sequences of common tasks) and • Processes (end-to-end methods) of healthcare providers and organizations, patients, and public health professionals Systems and Their Management • HIS that create and capture data serve as the foundation upon which all other informationand data-related capabilities depend • Essential building blocks of all other advanced uses of data and information – Clinical decision support (CDS) – Artificial intelligence (AI) • Data must emanate from real healthcare processes Systems and Their Management • Health informatics – The use of information systems and technology to redesign, improve, and recreate the way work is done in medicine, nursing, medical imaging, and public health – Focus on certain quality- or process-improvement objectives, which vary based on the setting – Comprise the “use” of the computer capabilities HIS provide to end users Systems and Their Management • Data – Primary uses involve transactions that support dayto-day activities of professionals and organizations – Must be aggregated and compiled to create meaningful information – Creating of information and ability to conduct analysis and gain knowledge are dependent upon the creation and capture of individual data elements Systems and Their Management • Data – ”Business intelligence” (BI): Value realized by flexibly analyzing comprehensive stores of data representing the totality of an organization’s/provider’s scope of activity – In health care, the BI concept leads to the notion of “clinical intelligence” (CI) Systems and Their Management • Research, policy, and public health – Data created and captured in HIS become available for research – Fuel the work of university researchers and enable analysts to measure health and provide evidence for improving efficiency and effectiveness of healthcare processes and outcomes – Policy makers rely on researchers’ findings – Data captures in electronic health record (EHR) systems are aggregated into databases Systems and Their Management Data creation/data aggregation Systems and Their Management • Research, policy, and public health – Public health officials harvest HIS data – Work expands from a individual to national to international in scope – Data are analyzed according to dimensions • Demographic, pathogen, disease, provider, payment mechanism, etc. – Options/variations available for a particular scope are determined by the available data Progression and Maturation of HIS Through the HIS Conceptual Model HIS progression and maturation Progression and Maturation of HIS Through the HIS Conceptual Model 1. Foundation – Progression begins with a strong foundation of technology and infrastructure and core HIS and their effective and proper management – Subsequent layers cannot exist without this Progression and Maturation of HIS Through the HIS Conceptual Model 2. Use (people, process, data, and informatics) – Health informatics • Support of healthcare activities and use of HIS to develop more effective workflows in the care of patients – Success is an outcome of the balanced involvement of people-process-technology • “Informaticist”: intersection of computers; the work of professionals using those systems; and the work of IT professionals designing, building, and implementing Progression and Maturation of HIS Through the HIS Conceptual Model 3. Learning/knowledge (Analytics: BI, CI, AI) – Use of data for gaining new knowledge begins when transactional data are created and captured in HIS through use of HIS software and then coalesced into databased and analytics platforms – These data are used for analysis and creation of CDS, BI, CI – AI employs newer technological capabilities • Machine learning, natural language processing Progression and Maturation of HIS Through the HIS Conceptual Model 4. Change (global HIS, policy, and research) – Eventually the progression and maturation of use of HIS and data they produce will improve our ability to conduct research, create effective policy, and improve public health through change – Path to change for the better is illuminated by evidence HIS Uses in Organizational and Community Settings • Mission, vision, and goals of each organization will drive types of systems “core” to its purpose • “What is the fundamental reason for using HIS?” – Requires thinking through types of systems and access to data different kinds of providers will need to deliver care and measure outcomes – Also need to determine types of HIS needed by different types of payers, patients/consumers, public health agencies, or research organizations HIS Uses in Organizational and Community Settings • Inpatient, outpatient, and ambulatory healthcare provider organizations – Anywhere care is delivered, HIS and data they house play an essential role – Internet was a game-changer in spread of HIS across all settings • Kaiser Permanente, Intermountain Health System, Veterans’ Administration were pioneering organizations – Current norm in U.S. health care is automation – Has created a multibillion-dollar HIS industry – HIS now connect to external partners HIS Uses in Organizational and Community Settings • Patients’/consumers’ homes – Mobile computing and use of Internet allow patients to access their records and providers, monitor personalize health data – Health-related information is accessible – Best outcomes in organizational performance and clinical care involve patient engagement – People expect to be part of their own healthcare process – Innovators are embracing means of personal connectivity and engagement using IT tools widely applied in other industries HIS Uses in Organizational and Community Settings • Payers, insurance companies, and government programs and agencies – Private insurance companies, government programs, self-pay • Public health organizations – Exist to monitor, protect, and improve public health – Serve as “safety net” by providing health care for uninsured/underinsured patients – Typically funded by government programs – Some exist to measure, monitor, and report statistics (CDC, Public Health Institute) Case Example: Vista’s Future: Exchanging Innovation for Commercialization? • Background • The challenges needing a solution • The solution • Anticipated outcomes of the new approaches HIS Uses in Organizational and Community Settings • Health information exchanges and regional health information organizations – Health information exchange (HIE): collaborative arrangements with goal of sharing patient-related health information – Aim is to improve timeliness of data availability, support clinicians in emergency situations, make existing data available in an emergency, reduce need to repeat tests – Interoperability: Health Information Technology for Economic and Clinical Health (HITECH) Act and Meaningful Use (MU) HIS Uses in Organizational and Community Settings • Health information exchanges and regional health information organizations – Regional health information organizations (RHIOs) Organizations designed to accomplish HIE have gained momentum as result of HITECH Act – Work in MU initiated through HITECH Act is being built upon by Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), which combines quality and process improvement activities into one program HIS Uses in Organizational and Community Settings • External regulatory, reporting, research, and public health organizations – Some third-party organizations set standards (metrics) for healthcare providers to use when measuring quality and cost of services – They then create benchmarks from aggregated data and issue report cards – Some external organizations are state or federal regulatory agencies – Some monitor key metrics regarding quality of care for a particular state or the country as a whole HIS Uses in Organizational and Community Settings • External regulatory, reporting, research, and public health organizations – The Joint Commission: quasi-regulatory organization that inspects and accredits hospitals based on ability to meet a rigorous set of scored criteria – The Cardiac Reporting Organization: established to monitor cardiac mortality rates nationally – Some third-party reporting relationships are voluntary to enable comparison to similar organizations in an effort to improve cost performance, quality of care, and transparency to communities HIS Uses in Organizational and Community Settings • External regulatory, reporting, research, and public health organizations – Secondary uses of data: data originally created and captured in the clinical and administrative transactions systems of health provider organizations – Primary uses of data: data created and housed in these providers’ HIS HIS Uses in Organizational and Community Settings Summary of Meaningful Use Criteria Stages 1, 2, and 3 HIS Uses in Organizational and Community Settings Primary and secondary uses of HIS data Data from the Institute of Medicine Report “Key Capabilities of an Electronic Health Record System: Letter Report.” Washington, DC: The National Academies Press, 2003. Summary • The layers of the HIS conceptual model provide a comprehensive view of the total scope of HIS activity – HIS and management – Health information – Business intelligence/clinical intelligence – Research, policy, and public health • HIS are used extensively in a wide variety of organizational and community settings